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Health Care Spending Guiding Principles
NPC established a set of principles to assess health care spending estimates and policies to ensure alignment with the goals of patient-centered care.
Case Study: Using Health Care Spending Guiding Principles to Evaluate "Will Reducing Drug Prices Slow Innovation"
NPC evaluated a study of drug pricing through the lens of its Health Care Spending Guiding Principles.
Patient-Centered Guiding Principles for Evaluating Health Care Spending
NPC established these principles to serve as a checklist to assess whether methods used for estimating health care spending are appropriate.
Patient-Centered Guiding Principles for Reforming Health Care to Address Rising Health Care Spending
NPC established these principles to assess health care spending policies to ensure alignment with the goals of patient-centered care.
The Patient’s Medication Access Journey: A Conceptual Framework Focused Beyond Adherence
The Pharmacy Quality Alliance, with support from NPC, developed a framework that defines a patient’s medication access journey and characterizes barriers frequently encountered while seeking…
Health Spending for Commercial Plans Is Predominantly Concentrated In Small Population of High-Intensity Consumers
NPC study finds spending on prescription drugs mirrors spending on other health care services, with a small subset of the sickest patients driving the majority of spending.
Limited Role of Patient Input in Specialty Drug Coverage Policies
A new study in JMCP found that patient input is rarely sought for coverage policies – although plans had processes to engage physicians and medical societies when developing coverage policies, no…
Affordability Is About More Than Drug Prices
A research survey from NPC and Xcenda found that potential government involvement in drug pricing would be unlikely to increase patient affordability.
Stakeholders Find Step Therapy Should Be Evidence-Based, Flexible and Transparent: Assessing Appropriateness Using a Consensus Approach
Stakeholders disagree on when step therapy is appropriate, but agree on a set of criteria about how to develop, implement, communicate, safeguard and evaluate step therapy protocols.
Assessing Consumer and Employer Willingness to Pay for New Medical Technologies
This study examines whether health care consumers and large employers would be willing to continue to pay for new medical technologies associated with significant improvements in patient health…
Do Patient Preferences Align with Value Frameworks? A Discrete-Choice Experiment of Patients with Breast Cancer
The study assessed patient preferences for aspects of breast-cancer treatments to evaluate the usual assumptions in scoring rubrics for value frameworks.
Underestimating the Value of an Intervention – The Case for Including Productivity in Value Assessments and Formulary Design
Research shows that including non-health care costs like productivity in value assessment frameworks can change the value assessment of interventions, impact on coverage decisions and subsequent…
Little Consistency in Evidence Cited by Commercial Health Plans for Specialty Drug Coverage
Evidence cited by payers in coverage decisions for specialty medicines varies significantly, with health plans only citing the same study in 15% of health plan coverage policies for a given drug and…
Current Landscape: Value Assessment Frameworks
This report analyzed seven existing U.S. value assessment frameworks, comparing and contrasting the strengths and limitations associated with each framework.
What's Been the Bang for the Buck? Cost-Effectiveness of Health Care Spending Across Selected Conditions in the US
This study was designed to assess whether increased medical intervention spending on prevalent chronic conditions has been a good investment over time.
Prioritizing Health Care Spending: Engaging Employees in Health Care Benefit Design
A case study shows that employees who are who are meaningfully engaged in deliberating and designing their health care benefits may have a more positive view of their coverage options.
Study of U.S. Commercial Health Plans Shows Widespread Variation in Coverage and Reimbursement for Specialty Medicines
Research published in Health Affairs shows that insurance coverage and reimbursement for specialty medications varies substantially, finding that only 15.9% of drug coverage policies were consistent…
The Effect of Medical Technology Innovations on Patient Outcomes, 1990-2015: Results of a Physician Survey
A survey published in the Journal of Managed Care & Specialty Pharmacy of U.S. physicians provides insight on their perceptions regarding which medical innovation has impacted outcomes the most…
Financial Impact of HSA-HDHP Reform to Improve Access to Chronic Disease Management Medications
According to an issue brief from VBID Health, providing pre-deductible coverage for medicines used to treat common chronic conditions could lower out-of-pocket costs and increase medication adherence…
A Comparison of Coverage Restrictions for Biopharmaceuticals and Medical Procedures
Payer evaluation and coverage of pharmaceuticals and medical procedures may differ independent of their clinical benefit. Therapy access depends on factor other than cost and clinical benefit,…